As many of you know, I am a member of the American healthcare system. Lately, I have been privelaged enough to hear several health care "futurists" and philosophers talk on world and American healthcare. That being said I will pose a question to you all.

In healthcare, or any service field for that matter, you can have low cost, accessibility and quality. However, you can only have two of these things at the same, and this is especially true in medicine. For example, in the U.S. high quality and easy accessibility have been "picked" at the price of higher costs. Canada and "socialized" European countries have decided on high quality and low costs at the price of more difficult accessibility. China and Russia have chosen easy accessibility and low costs at the price of quality. My question to you all is what two of the three would you pick for your health care system, and how would you justify the loss of one of the three?

(And if you're going to somehow give me an example of how you could in fact have all three, I'd like for you to give me an example of where this is the case and an economic model of how you could possibly support it.)

i didn't understand the poll the way i should understand it.
after editing.
ammm israeli healthcare system is good quality amm then i guess just lower the price.

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Last edited by FederalBI on Aug-08-2004 at 15:01

Very interesting.

I'd have to go with "Quality and Accessibility," because there really is no excuse, in a nation as wealthy as the United States, to not have healthcare that is accessible (and affordable) to every citizen with a reasonable degree of quality.

If the US were a poorer nation, then you’d also have to factor in the costs more in your analysis.

Now, we don't have to go completely "socialized," but some combination of government involvement, regulation, and private enterprise like we have now would still meet the goal.


The HMO industry at this time I would classify as predatory in nature, but it can be regulated in a way that ends this.

I would also argue that the HMO industry operates in a manner that reduces its costs at the expense of both quality and accessibility (but most notably quality).

It’s ok if you get an ear infection or something, but if you get truly sick you’re often simply fucked.

To pay for covering all citizens with healthcare, you'd simply need to cut back on corporate welfare and some of the bloated pentagon budget to pay for it without raising taxes.

This would be quite a feat though considering the grip large corporations and the military industrial complex currently have on Washington.

Last edited by DaveSZ on Aug-08-2004 at 14:55

i would say Quality and Accessibility but not the US way, more the EU way, accessable to everyone.

If that is too much to take for a country (which it is not) i would rather see Quality and Low cost.

err, don't you mean "Pick two." ?

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quality and low cost.
People should have to overcome their lazyness to gain access to it. im assiming that by accessability you mean people have to go through more paper work and beauracracy.

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If God is the answer, it must have been a very stupid question.

What exactly do you mean by low cost? Do you mean low cost for individuals or for the government?

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1+1=10

I am for the highest quality and accessibility. Despite what John Kerry may want you to believe, I do not believe that healthcare is an implicit "right", and I don't think there is a very pursuasive argument to prove otherwise. If you want to lower the cost, that's fine, but the result is a cheap clinic or HMO. However, if you don't have the funds to go to a more costly/higher quality facility, you're not exactly in a position to complain. Like Neophono said, you can have 2 out of 3. Don't try to rationalize the 3rd into the package, as that's what creates the problem.

Interesting/good points, Neophono.

Okay, better definitions:

Low cost - Low cost to primarily the patient, but also reduced costs to the health care insurance provider, be it the government or HMO.

Accessibility - Ease of seeing a health care provider. For instance, an appointment to see a family practice doctor in the states can *usually* be made days after a call is made. In other countries this wait can be weeks to months for non-critical visits.

Quality - Kind of obvious, I'd guess. The quality of the healthcare you are being given in terms of both technology and scope.



I personally believe that part of the answer in the American health care system is higher copays. Americans, per person, demand four times the amount of health care dollars as the nearest country (Japan). If you look at just emergency room visits, only 7% are actual emergencies, and over half of the people suffering from these non-emergencies know they do not have an emergent reason for visiting the ER. The difference is that an ER visit costs hundreds to thousands of dollars, whereas waiting to see a family practice doc costs a fraction of that. To add insult to injury, 1/3 of ER vistors do not pay a dime and 1/3 pay a reduced amount. (Who says there's no free health care in the US? ) So you only have 1/3 of people actually paying for their visits. My solution would be to drive up copays to keep people without emergencies from abusing the system. This would lower costs for everyone and also keep non-emergencies from clogging the system.

quote:

Originally posted by NeoPhono Okay, better definitions: Low cost - Low cost to primarily the patient, but also reduced costs to the health care insurance provider, be it the government or HMO. Accessibility - Ease of seeing a health care provider. For instance, an appointment to see a family practice doctor in the states can *usually* be made days after a call is made. In other countries this wait can be weeks to months for non-critical visits. Quality - Kind of obvious, I'd guess. The quality of the healthcare you are being given in terms of both technology and scope. I personally believe that part of the answer in the American health care system is higher copays. Americans, per person, demand four times the amount of health care dollars as the nearest country (Japan). If you look at just emergency room visits, only 7% are actual emergencies, and over half of the people suffering from these non-emergencies know they do not have an emergent reason for visiting the ER. The difference is that an ER visit costs hundreds to thousands of dollars, whereas waiting to see a family practice doc costs a fraction of that. To add insult to injury, 1/3 of ER vistors do not pay a dime and 1/3 pay a reduced amount. (Who says there's no free health care in the US? ) So you only have 1/3 of people actually paying for their visits. My solution would be to drive up copays to keep people without emergencies from abusing the system. This would lower costs for everyone and also keep non-emergencies from clogging the system.

That's a good idea. My copay is only $15 and I bet just by paying $5-10 more(multiplied by millions of people), a lot of money could be saved on the back-end.

I'm also still a proponent of tort reform. I think that upwardly spiraling insurance costs are one of the sources of the healthcare problem. Make it more affordable for a health-care organization to operate and costs will be lower for all.

I'm a bit intrigued by this one..

I think that us Australian's are quite lucky with our health care system. Neophono mentions that theres an opportunity cost in only chosing 2 of the 3 options in assessing healthcare.. For some reason, i dont agree.. not in australia anyway.
Let me explain.

Accessibility - Our public hospitals, although having waiting lists for elective surgery, are virtually queue free. I have walked into the emergency ward several times and recieved treatment without waiting more than 20 minutes.

Quality - I think that the quality of treatment in this country is second to none (not literally, but it's pretty damn good). I mean, our royal childrens hospital here in melbourne greets patients from all over the globe (including the US), and in this sense is the best in the world. So quality isnt a problem.

Low cost - Our health care is virtually free to the consumer (thankyou medicare). Bulk billing at our General Practitioners is readily available (some may like to disagree tho), and our prescription drugs are dirt cheap. (top-line, ground-breaking medicines go for as little $5 a pop here)

At the moment we enjoy the best of everything, but I can understand that there needs to be a tradeoff, and i think that our health care system is turning more and more into an american system. Talks of increasing prescription costs, and an imminent collapse of our medicare, suggests that our dirt cheap system is not viable. Looks like the consumer is enjoying low cost, but the government is getting slammed with the high costs.

I dont know... which one, of the three, would you want to give up though?? too hard to answer.

On a personal aside, I think the idea of health care being expensive is an interesting one. In the US, people will go out and buy $6000 flat screen TVs, homes that are tens of thousands of dollars above their income range and cars that guzzle both gas and maintenance fees. Then, when they have to pay a several hundred a month in health insurance, it is too expensive. If I had to choose (as I've had to) between paying for a fancy car or expensive TV, or paying for insurance, so that if I get sick I WON'T DIE, the choice seems pretty obvious. All of those other material possessions are pretty insignificant if you're dead. I just can't understand why paying several hundred dollars a month for a TV or car is fine, but when health insurance gets to that range, it's outrageous.

(One reason I say this is because the majority of individuals without health insurance could afford it, but choose not to buy it.)